支气管扩张症的外科治疗56例分析

Analysis of 56 cases of bronchiectasis surgical treatment

目的探讨支气管扩张症的外科治疗经验。方法分析我科行手术治疗的支气管扩张症56例临床资料,总结手术指征、术前准备措施、手术技巧和并发症。结果 56例患者30例行单纯肺叶切除,26例行联合肺叶切除,术后13(23%)例患者出现房颤、室上速等心律失常,3(5.4%)例出现心功能不全,19(34%)例肺部感染。1例支气管残端瘘。56例患者中治愈35例(62.5%)、好转21例(37.5%)、死亡0例(0%)。无围手术期死亡病例。结论外科治疗是终末期支气管扩张症患者有效的治疗方法,特别是大咯血患者,可挽救患者生命。

Objective To evaluate the surgical treatment experience of bronchiectasis. Methods The clinical data of 56 patients with bronchiectasis were retrospectively analyzed, which included operative indications, preoperative preparation, operation skills and op- eration complications. Results 30 patients were treated with simple pulmonary lobectomy and the rest 26 patients combined with pulmo- nary lobectomy. The postoperative complications of cardiac arrhythmia occurred in 13 patients, cardiac dysfunction in 3 patients, bron- chopleural fistula in one patient, and pulmonary infection in 19 patients respectively. Through surgical treatment, 35 patients were cured, 21 patients were improved. There was no death reported during the perioperative period. Conclusion Surgical treatment is an effective way for the bronchicctasis patients in terminal stage, especially for those massive hemoptysis patients, and the treatment effect could be im- proved through sufficient preoperative preparation, cxcellent double-lumen intubation technique and perioperative management.